Background/Purpose: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by inflammation, joint pain, destruction of the synovial membranes and metabolic alterations due mainly by the liberation of tumor necrosis factor alpha and interleukin-1 beta, leading to rheumatoid cachexia. Dynamic exercise has demonstrated to improve muscular function and strength, as well as joint mobility without negative effects on RA. Also, a diet focused on the consumption of certain fatty acids like the Mediterranean is recommended to reduce inflammation. Thus, the aim of this study was to assess the effect of a dynamic exercise program in combination with a Mediterranean diet (MD) in strength, joint mobility and disease activity in women with RA.

Methods: We undertook a randomized controlled trial including 95 women with diagnosis of RA (2010 ACR/EULAR classification criteria). Handgrip strength, goniometry and DAS28 score were evaluated at baseline and 6 months follow-up. Patients were classified into four groups: G1 (n=28) with dynamic exercise and MD; G2 (n=21) with dynamic exercise only; G3 (n=26) with MD only, and G4 (n=20) controls. G2 and G4 were given general dietary recommendations as well as G3 and G4 were given general physical recommendations. All patients received standard medical treatment for RA prescribed by a rheumatologist. Percentage change was calculated to assess the magnitude of effect and ANOVA test was used for comparison between groups. The results were adjusted according to functional class following the ACR guidelines.

Conclusion: Dynamic exercise in combination with MD improves physical capacity, muscular strength and joint mobility as well as disease activity when compared with either therapy individually or controls.